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Repeat bone mineral density scans do not appear helpful for predicting fractures in most older women

Repeating a bone mineral density (BMD) scan up to eight years after an initial BMD appears to provide little additional benefit for predicting fractures among older postmenopausal women, according to a report in the January 22 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

BMD as measured by a method known as dual-energy x-ray absorptiometry helps physicians predict fractures and has become the gold standard for osteoporosis screening, according to background information in the article. Current guidelines recommend screening all women for osteoporosis using BMD measurements at age 65. However, there is little evidence supporting the use of repeat BMD testing for evaluating fracture risk, but such additional tests are commonly performed in clinical practice.

Teresa A. Hillier, M.D., M.S., of Kaiser Permanente Northwest/Hawaii, Portland, Ore., and colleagues measured total hip BMD in 4,124 older women (average age 72 years) in the Study of Osteoporotic Fractures between 1989 and 1990 and again an average of eight years later. The researchers calculated the rate of change in BMD and followed the women for an average of five years after the repeat BMD to see which women developed fractures. Participants were contacted by postcard every four months and fractures were verified through radiology reports and x-ray films.

During the follow-up period, 877 women had a non-traumatic non-spine fracture, including 275 hip fractures, and 340 women developed a spine fracture. On average, the women's initial BMD measurements were low--compared to young women--but not in the osteoporotic range; the group lost an average of .59 percent of their bone mass per year between examinations. "In each of the four BMD models (initial BMD, repeat BMD, change in BMD between the two examinations, and initial BMD plus change in BMD), BMD was a significant predictor of incident non-spine and hip fracture risk, and was associated with m
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Contact: Terry Fitzpatrick
503-335-6602
JAMA and Archives Journals
22-Jan-2007


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